As the wars rage on in Iraq, Afghanistan and
beyond, our Armed Forces continue to be prepared for
lengthy overseas deployments, often serving multiple
or extended tours of duty. This has created
unparalleled stress and trauma; not only on those
who serve, but also on their families during these
deployments and upon their returns. Families make
tremendous sacrifices so that these men and women in
uniform can provide military service and advance the
cause of freedom throughout the world. Families are
also a vital support system to these service members
and their roles can not be underestimated.

When service members go to war, the nuclear and
extended families also “go to war” and are impacted
by the outcomes. Unfortunately, combat can result in
severe injuries, disabilities and casualties. Many
veterans have now returned home to thousands of
families who face daunting challenges and may be
unprepared to care for them. Lives are altered and
rearranged at all levels to care for the physical
injuries and emotional needs of loved ones. Many of
these family members, including children, experience
a change in their roles and have become
“caregivers.”

Fortunately, in this day and
age, caring for our military members also includes
tending to the well-being of their families and
caregivers. A multitude of programs and resources
are now available or are being developed to assist
our Armed Forces members as they return to duty or
civilian life and to assist their family members as
they face new roles and expand their capacity to
provide care.

Family Transitions and
Support:Upon a veteran’s return from
the battlefield, the entire family will go through a
period of transition that includes restoring trust
and wholeness in the family circle. This is the most
important time frame to seek support and gain
knowledge about the changes and difficulties that
may be present.

In recent years, the VA
(Veterans Administration) identified a six-phase
“Cycle of Reintegration.” The phases also directly
involve and impact caregivers and family members as
the veteran reunites with them.

Phase One: “The Honeymoon”: elation and
joy, relief and celebrationPhase Two:
“Disillusionment”: role changes, life at home
doesn’t feel the same, pace of life is different,
new stresses may emergePhase Three:
“Alienation”: no one “gets it,” “I want to go back,”
risk of drug/alcohol abuse, frustration, boredom,
feels distanced from the military routine and
comradesPhase Four:
“Engagement”: intervention by the family, motivation
to change, counseling/support groups, return to
work, seek new routines and connections
Phase Five: “Acceptance”: realization that
life is different, “I am different,” “you are
different,” relearning takes place, negativity is
replaced by gratitudePhase Six:
“Finding a New Normal”: aiming for stability and
lifestyle balance, prioritizing life issues, working
together to set new goals

Understanding
these phases and utilizing counseling support
services through the military or local programs will
be a key to a positive adjustment for the veteran
and the entire family system.

The need for
family support during times of deployment and upon
the return of service members has always existed.
Family Readiness Groups (FRGs) and support groups
are available through each branch of the Armed
Forces to provide social and emotional support,
outreach services, and information prior to, during,
and in the aftermath of military separations. The
camaraderie and strength that develops between
military families that face uncertain times together
is priceless.

Military family retreats,
provided through many military branches, are another
example of support for families and caregivers. They
provide combat veterans and their families with the
education, training and skills needed to manage
their lives after serving in a war. The retreats are
often held in a rural, private area, are staffed by
trained volunteers and counselors, and are usually
free. Youth and children’s activities are provided
along with educational and support sessions for
veterans and their spouses. These topics may
include: self care, relaxation techniques, stress
reduction, sleep solutions, problem-solving skills,
money management, intimacy issues, communication, VA
services and more.

Positive results have
come from these retreats as families have attested:
“This experience has pulled our family from the
brink of destruction,” “The retreat gave our family
a boost of self-worth,” and “Everybody faces
challenges with the aftermath of war. It is good to
know, see and feel that it is normal.”

Taking Care of the Caregiver:
Family members may face the prospect of starting a
new chapter in their own lives if their loved one
returns from military service with an injury or
disability. Many have had to put life on hold, leave
jobs or change residences to care for a spouse,
adult child or significant other. Caregiving can be
overwhelming as one tries to meet all of the
emotional, physical and medical needs of a veteran.
Mourning the loss of a “normal” life and
relationship prior to the war may also occur. At
this point, it’s important for caregivers to accept
that things have changed and to surround themselves
with their own spiritual, emotional and physical
resources.

The health and emotional
well-being of the veteran’s caregiver also needs to
be a priority. If not addressed, caregiver fatigue,
illness and impatience can directly reflect on and
impact the quality of care that one is able to give.
An important analogy can be found in our airline
industry. Just as the flight attendant instructs
passengers to use the oxygen mask on themselves
first and then assist the person next to them, so
must the caregiver follow the same important
instructions.

Caregivers who learn what
help is available to veterans and how to access that
help will feel more in control of a complex
situation. Some ideas are:

Become educated
about the veteran’s medical condition, whether
physical or emotional.

Learn to communicate
with members of the health care profession. Write
down questions prior to appointments and, if needed,
have an additional person attend appointments to
gather important information.

Keep good
medical records and summaries of office visits.
Bring identification and health insurance cards,
plus names and doses of the veteran’s medications to
the appointments.

Learn the routines and points of access with the
medical facilities used by the veteran. This
includes office hours and how to reach health care
providers, schedule appointments and transportation.

Inquire about assistive technology devices and
utilize home care and skilled-care services.

Find out about benefits that are available through
the military and Department of Veterans Affairs.

Additional Caregiver Keys Include:
Asking for help (it is a sign of
strength)

Taking breaks to restore energy

Making one’s own health needs and medical
appointments a priority

Learning proper
caregiving techniques such as lifting, transferring,
or wound care from medical professionals at the VA
or other medical facilities

Connecting or reconnecting with a faith-based
community for support

Establishing a circle
of support around the family that includes
professionals, relatives and (military) friends who
are able to share the care and reduce stress

Community Support is Priceless:
Fostering community support for veterans and
military families is essential to their readjustment
and stability. If the community is committed to
helping and supporting them, the period of
readjustment will be more successful. This support
can take many forms, and state governments and
citizens across the nation are proposing new
initiatives and partnerships to help speed up and
expand services to veterans and their families.

The Minnesota National Guard, for example, has
been heralded for a program that hopes to change how
soldiers and airmen are reconnected to their
families and communities. “Beyond the Yellow Ribbon”
is named as a reminder that the support of soldiers
and their families must not end when they return
from their deployment and the yellow ribbons are
removed. The program offers a roadmap of important
steps to take care of the soldier’s physical and
emotional health, personal business/benefits,
health, education, legal issues, employment, and
family needs including marriage enrichment and
parenting.

Chaplain Major John Morris of the
Minnesota “Beyond the Yellow Ribbon” campaign made
this analogy. “Going into combat is a little
like canoeing across the lake of life. When you
leave for war, it’s like standing up in the canoe
and upsetting the balance of family life. While
you’re gone, your family takes over the paddling and
tries to survive. When you return, you climb back
into the canoe, and flip it, swamping it. Many
families have been faced with bailing out that
canoe, and they suffer extreme duress over something
they thought would be joyful. A lot of families can
become exhausted from paddling that canoe through
life.”

Chaplain Morris encourages returning
veterans to seek whatever help they need to make a
successful adjustment back into their families,
relationships and community lives.

Another
example is a program developed by Mary Pawlenty,
wife of Governor Tim Pawlenty of Minnesota, called
the “First Lady’s Military Family Care Initiative.”
She has brought together service groups, community
organizations and faith-based groups throughout the
state, all of whom have expressed a strong desire to
provide a wide selection of volunteer services to
military families. A simple task like mowing the
grass, assisting with chores or preparing a meal can
go a long way toward helping a family in their time
of need.

“Homes for our Troops” (part of
the Defense Department’s “America Supports You”
program) is yet another option available to wounded
service members and their families. The program
builds or remodels homes (at no cost) to accommodate
the specific needs of the severely wounded soldiers
who are returning from Afghanistan and Iraq. Their
goal is to adapt, build and remove obstacles in the
homes to meet the needs of a veteran who is in a
wheelchair or who faces injuries that hinder
mobility. The organization provides services
specifically to troops who are double amputees,
paraplegic, quadriplegic, have severe post-traumatic
stress disorder, or are severely burned. “Homes for
Our Troops” has successfully partnered with the
communities where veterans live to help fund the
projects by holding benefits/fundraisers, donating
materials and utilizing local professionals.

Veterans Administration Role:
The VA supports caregivers as they support our
veterans, including those who care for recently
wounded or ill veterans as well as aging veterans.
Although the VA system has been inundated with
requests for care and is often criticized for their
service limitations, strides continue to be made
toward greater care options and contracts with
existing programs.

For example, in December
of 2007, the VA announced that $4.7 million was
allocated to help caregivers. Since family
caregivers are on the front lines to care for
veterans, the goal of the VA is to form a
partnership between family caregivers, the VA itself
and community-based agencies.

The VA is now funding “caregiver assistance pilot
programs” to expand and improve health care
education and provide needed training and resources
for caregivers who sacrifice to care and assist
disabled and aging veterans in their homes. The
eight pilot programs across the nation will explore
opportunities for providing social work services,
extended care, home safety evaluations and volunteer
support. The VA plans to contract with local
programs such as home health agencies, medical
equipment companies and adult day programs for
respite care. Many of the projects will also use
technology to offer support through computers, video
conferencing, and teleconferencing, especially for
caregivers that live in remote areas or are unable
to leave home to participate in support activities.

The majority of our service members are extremely
strong and resilient; however, the emotional
battering and stress of war can ultimately lead to
mental health consequences. Veterans from Operations
Enduring and Iraqi Freedom, who have accessed VA
health care, have reported mental health concerns
including PTSD (post traumatic stress disorder),
substance abuse and mood disorders. Living with and
caring for veterans with these issues is difficult
and can change the way that family members relate to
one another. That’s why it is crucial for those who
care for our veterans to become educated about these
obstacles and learn how to recognize when help or an
intervention is needed.

Veterans’ Centers
around the country offer support for mental health
needs, readjustment issues, marriage and family
problems, and medical caregiving. Support groups are
also offered at many of these centers to help
caregivers understand the veteran’s personal
challenges such as anxiety, depression, difficulties
with their work/life balance, and grief and loss
issues. For those who reside in rural areas, the VA
is now networking with county and private human
service providers to offer education and counseling,
including bereavement support for families of fallen
service members.

Military OneSource is yet
another support option. This free 24-hour service,
provided by the Department of Defense, is available
to all Guard, Reserve and active duty members and
their families. Consultants provide information on a
wide range of issues that affect daily life and
offer counseling. The program can be reached by
telephone at 1-800-342-9647 or through the Web site
at www.militaryonesource.com.

Providing
care and support to our veterans can be challenging,
yet options and solutions are more readily available
than ever before. The VA and communities across the
nation are forming partnerships and working
diligently to support veterans, their families and
caregivers. Military institutions recognize the
sacrifices made on the home front while we are at
war and pledge to support family programs while
keeping the well-being of our servicemen and women
at the forefront.

This article is written
in honor of my husband, Col. Patrick Dwyer who
served in the Gulf War, and all members of our
military who serve bravely and make personal
sacrifices for peace and freedom.